Cook County News Herald

Hospital anticipates Affordable Care Act challenges




The Cook County North Shore Hospital board spent considerable time at its June 20, 2013 meeting discussing how to avoid discouraging local residents and current employees from applying for the open controller job. The meeting was the last one for longtime controller Yvonne Gennrich, who took a job with another hospital nearer to family.

The new controller will be an employee of St. Luke’s Hospital, North Shore Hospital’s administrative partner, as this will afford access to potentially useful information that would not be available if the controller were an employee of North Shore Hospital.

The job description presented at the meeting listed the minimum qualifications as a bachelor’s degree in accounting, business, or a related field and three years related work experience including years of supervisory experience in a hospital or healthcare-related organization or other equivalent experience. The preferred qualifications included an MBA.

Board member Justin Mueller said he received a note from a hospital employee who was concerned that the preferred qualifications would eliminate local residents from the running.

Yvonne Gennrich, who became the controller within a year of being hired by the hospital in the payroll/ personnel department, said she believes they have some people on staff who would be very qualified for the job. She had very little experience in the health care industry when she started, she said, and she has no more than a high school education. In her over 15 years with the hospital, she said, she has been given opportunities to learn what she needed to know. The people working for her have strong interpersonal skills and character. Technical expertise does not matter if people skills are absent, she said.

“Thank you for the opportunity to work here,” Gennrich said.

Board member Tom Spence wondered if they could broaden the required experience to include an associate’s degree with the expectation that more training would be sought or comparable experience in lieu of a bachelor’s degree.

St. Luke’s President John Strange said St. Luke’s is flexible when hiring and sometimes asks a new employee to seek a certain degree within a specified period of time. “The technical end of this is getting more and more complicated every day,” he said, adding that “working knowledge” is more important than a certain degree.

Federal health reforms are going to make the technical end of the job more complex, St. Luke’s Vice President Sandra Barkley said. Strange agreed, saying that the Affordable Care Act will be “unbelieveably complex,” and dealing with it will require accounting, computer, and human resources knowledge. The hospital’s chief financial officer will be a “critical position” going into the future, he said.

Administrator Wraalstad said she believes a business degree could be important for the job. “Education is an important piece,” she said.

The board discussed the fact that because the controller will now be an employee of St. Luke’s, a current North Shore Hospital employee could possibly lose accrued benefits if they took the job. Strange said they have a management development program and the new controller would have advancement opportunities as a St. Luke’s employee. St. Luke’s is not requiring that the new controller be an employee of St. Luke’s.

Some people are wondering if other employees or an employee group such as the nurse’s union would rally to become St. Luke’s employees if the controller were hired as a St. Luke’s employee, board member Sharon Bloomquist said. She called it a potential “slippery slope.”

Strange said he was open to the new controller being en employee of either organization. “Our goal is to get the best candidate,” he said.

The board consented to changing the minimum qualifications to include a bachelor’s degree or its equivalent in experience alson with work experience directly applicable to the job. The position is being advertised.

Negotiations with BCBS

The hospital continues to work with Blue Cross Blue Shield of Minnesota (BCBS) in regard to its requirement that the hospital implement a new and more complex billing system by January 2014. Earlier this year, the company announced to critical access hospitals throughout the state that the new system would be required for payment.

“They’re getting a lot of pushback from critical access hospitals,” said John Strange.

Hospital Administrator Kimber Wraalstad said she cannot work with other hospitals in negotiating with Blue Cross/Blue Shield because of anti-trust laws that prohibit them from sharing their costs with each other, which could lead to price-fixing.

Wraalstad said she had a hard time coming up with a date to meet with BCBS in Duluth, even though she gave them 11 possible dates. They said they would not come up to Grand Marais because it was too far from the Twin Cities. She is sharing her struggles working with the company with the Minnesota Commissioner of Health, the attorney general, and the Minnesota Hospital Association.

Financial report

Controller Gennrich reported that revenue was lower than expected for the month of May. Swing bed occupancy has been about one-third of what had been budgeted, mostly because people are not staying as long as anticipated. Emergency room income is down by more than 20 percent from what was budgeted.

Grant

The hospital received an $8,000 grant from the North Shore Health Care Foundation for a GlideScope video laryngoscope to enable the quick insertion of airway tubes.

Affirmative Action Plan

The board approved the 11th revision of the hospital’s Affirmative Action Plan first adopted in 1989. Administrator Wraalstad said the hospital meets legal requirements for gender and ethnic diversity.

Nine of the hospital’s 152 employees are minorities. One hundred twenty-four are women and 28 are men.

“They’re sure watching out for women and minorities,” said board member Sharon Bloomquist, “but what about the guys?”

Gardens

Seeds have been planted for the hospital’s raised-bed gardens. If the cold weather persists, Wraalstad said, they will have an abundance of beans and lettuce.



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